This form can be
fill out, by your teen to help involve them in the development of their
IEP.

Second section:Students
Strengths and Key
evaluation Results Summary

What
are the student’s educational strengths, interest areas, significant
personal
attributes and personal accomplishments? What
is the student’s type of
disability(ies), general education performance,
including MCAS/district test results, achievement towards goals and
lack
of expected progress, if any?

Are all six questions addressed in this sections and is there a
summary
of the results for each of the evaluations included?

First part of the Questions:1. Educational Strengths?2. Interest areas?3. Significant personal attributes and personal
accomplishments?

Second part of the Questions:4. What is the student's type of
disability (ies)?5. General education performance, including
MCAS/district test results?6. Achievements towards goals and lack of expected
progress?

Key evaluation Results Summary - Is there a summary of the each of the
evaluations (Neuropsyc, Educ, S&L, OT, PT,
etc.) reports?

A summary is condensation of
the essential or main points. Is the summary for each evaluation
report one paragraph, of 4-8 sentences per evaluation
report? A summary that states the students strengths and
weaknesses found through
the evaluation. Most evaluations reports have a 'Impressions'
or 'Summary' section, that already pulled that information
together.
The summary can include what the diagnose (ies) for the student (Even
though there
is a place in the IEP in this same section, that ask what is the
disability (ies).

You do not
want a list of scores (these scores are meaningless
without the interpretation).

Third sectionVision Statement:
What
is the vision for this student?Consider the next 1 to 5 year period
when developing
this statement. Beginning no later than age 14,the statement should be based on the
student’s preferences and interest, and should include desired outcomes in
adult living, post-secondary and working
environments.

Does your "Vision Statement" state what
you see your child
doing in 1-5 years into the future?

Does this include your long term goal for your child (Your
dreams, your hopes)?

Consider the number sense,
patterns, relations, and functions, geometry and measurement and
statistics and probability stands.

Other Curriculum Areas

Specify:

Second section:Did the following questions get answered?How does the disability affect progress in the curriculum
area(s)?

Third section:What type(s) of accommodation is necessary for the student
to make effective progress?

Last section:At the bottom of the page:

Content: What modifications are needed?

Methodology/Delivery of Instruction: If any specialized
educational program is to be used, it should be stated
here. Delivery of Instruction is where, the size of instructional
group is listed (i.e.
small group), any strategies for the teacher/aide that would
assist in this student's learning in the classroom.

Performance criteria: How will the student's performance,
in the general education curriculum be measured?

Are
there any exception or ways of measuring the students knowledge of a
subject that would not be limited by their disability?

Do NOT feel limited by the amount of space provided,
multiple copies of this page can be used.

At the high school level, it is not unusual to have one page
per subject, depending on the child's needs.

Page IEP 3 (PLEP B):

IEP page 2 and 3 format are very similar, IEP 3 covers all the
other
areas of education.

(IEP 3 is for all related services)'Present Levels of Educational Performance (PLEP)''B: Other educational needs'

"The Team must also take a broader look at the student's overall
involvement with the school including participation in extracurricular
and other nonacademic activities ...."

"The Team may consider how the student communicates with others, how
the behavior affects their learning or the learning of others, how
assistive technology could support effective progress or how the
disabilities affect transition to post-secondary activities."

For students age 14 - 22, what would be needed for transition
after high school?Under "Age-Specific Considerations" a transition statement
for preschool age children, student age 14 - 16, and students age 17- 22 should
be included.

Second Section:How does the disability affect progress in the indicated
area (s) of other educational needs?

Third Section:What type of accommodation, if any is necessary for the
student to make effective progress?

Last Section:At the bottom of the page:

Content: What modifications are needed?

Methodology/Delivery of Instruction: If any specialized
educational program is to be used, it should be stated
here. Delivery of Instruction is where, the size of instructional
group is listed (i.e.
small group), any strategies for the teacher/aide that would
assist in this student's learning in the classroom.

Performance criteria: How will the student's performance,
in the general education curriculum be measured?

Are
there any exception or ways of measuring the students knowledge of a
subject that would not be limited by their disability?

Do NOT feel limited by the amount of space provided,
multiple copies of this page can be used.

Page IEP 4:

(There will be several of these pages, we like the format of 1
goal per page.)The goals are the most important part
of your student's IEP.Title of the goal page: 'Current Performance Levels/Measurable
Annual Goals'

Goal # n: type

Do you have a goal for each area of need for your child
(i.e. Reading, Writing, Spelling, Math, Social/Emotion, etc.)?

There are three sections to each goal:

Current Performance Level:
what can the student currently do?

Measurable Annual Goal: What
challenging, yet attainable, goal can we expect the students to meet by the
end of this IEP period?

Benchmark/Objective: What will the
student need to do to
complete this goal?

Page IEP 5:

Check the 'Service Delivery' page, look at all three
sections.

Check where each service is to take place, is it correct?A. Consulting services: are not a direct service to your
child.Consulting can be a phone conversation or meeting.Some examples would be:

the classroom teacher consulting with an outside therapist
or other member of the team.

the aide meeting with another members of the team
(therapist or parents).

planning time for the team (that could be use to discuss
your child program).

B. Services within the classroom: services listed here mean
your child will be receiving these services in their regular classroom
setting.
C. Services to take outside the classroom: services listed
here mean your child will be receiving these services outside their
regular classroom (i.e. learning center). These are the direct
services to
your child.

Check if there is a service for each goal in your IEP,
under the heading of "Focus on Goal #'?

Check what is listed under "Type of
Personnel", it should be the specific type of provider.
(It is not the person name providing), it needs to be specific:

"special education
staff" or "Sped staff", is too vague, does not tell you who will be
providing the service.
It must state if the service is to
be provided by a special education teacher, "Sped Teacher", "Sped tutor", "Sped
asst.", "OT", "OT asst.", etc.

It must be clearly be noted when a service is provided by an assistant
rather than a fully certified provider,
and the law of course requires that anyone not fully certified must be
overseen and trained by
a certified provider in that field (OT, SLP, etc.).
Examples would be: If your child
receives 1/2 hour OT in class with an OT asst. or COTA and 1/2 hour OT out of
class with a certified OT, those two must be listed as such, separately on the
grid.

According to the Special Education Regulation:28.06(2)(d)(1): The school district shall determine specific instructional personnel and shall work jointly with the Team

to arrange the specific classroom or school, . . . .

Check what is listed under
"Frequency and Duration/Per Cycle", it should be clearly written,make sure you understand the amount
of time your child will be receiving for services.

"On-Going"
or "As Needed", is too vague, and there is no commitment to time.
(See Federal Law 300.347(a)(6)).

Always check the
dates that are listed for the time period.

Are summer services
listed here or on separate page?

Page IEP 6:

Under 'Non participation Justifications' review what
the school wrote.

There are two questions under 'Schedule
Modification', one about shorter school day or school year.

One about longer school day or school year.

For summer services or Extended School Year (ESY), the
question on the form is:

'Longer: Does this student require a longer school day or longer
school year to prevent substantial loss of previously learned skills
or substantial difficulty in relearning skills?' Yes or No?

Page IEP 8:

Under 'Additional Information' is used to include any
information that has not
been document any other place within the IEP. The form lists 3
questions:
"1. Include the following transition information:

the anticipated graduation date;

a statement of interagency responsibilities or

needed linkages;

the discussion of transfer of rights at least one
year before age of majority;

and a recommendation for Chapter 688 Referral.

2. Document efforts
to obtain participation if a parent and if student did not attend
meeting or provide input.

3. Record other relevant IEP information not previously stated."

This is a good place to list
your attachments.

Behavior Management Plan (BMP),

Statement about discipline policy to be used for
your child.

Assistive Technology Plan (ATP)

Transition Plan for this student next step in life (i.e. after
high school)

When the team will begin to discuss summer
recommendations.

This section should not
include goals, (there is a separate page for goals, IEP 4) If goals are
listed in this section, it means no requirement for goal measurement,
benchmarks or
progress reports.

Signature Page(IEP
8):

Reviewing your child's IEP:

You have 30 calendar days to response to the school (30
calendar days, even during the summer months and vacations).

It is in your best interest to review the IEP and contact
the team chair about any issues that you understood differently from
the
team meeting (refer to your notes, tape recording, or other team
members).
Put these changes in writing to the team chair.

Changes can be made to the IEP as long as your response
within the 30 calendar days.

28.05 (7)(a) No later than
thirty (30) days after receipt of the
proposed IEP and proposed placement, the parent shall:

1.
Accept or reject the IEP in whole or in part; request a
meeting to
discuss the rejected portions of the IEP or the overall adequacy of the
IEP; or if mutually agreed upon, accept an amended proposal; and

2. Accept or
reject the proposed placement.

(b)
Upon parental response to the proposed IEP and proposed placement, the
school district shall implement all accepted elements of the IEP
without delay.

After you receive the revised IEP you need to keep track of
how many days it has been since you signed the consent for the initial
evaluation or reevaluation. You now have up to the 45 school days since
that date. This informal updating progress stops when the school
district is not willing to make any more changes.

Unsigned IEP:

Have no legal significance,
they mean nothing. An IEP not signed can't be implemented (unless the
school district implements them unilaterally).

You can either object in writing
or will lose at due process.

Signing your child's IEP:

After you have gone through the 30 day review period,
and you have put your changes in writing to the Team chair, if the Team
chair is not willing to make any other changes to your child IEP, it is
time to start the formal process, signing your child's the IEP.

Below are the possible
chooses:

Response Section , List 4 choices:

'I accept the IEP as developed'

'I reject the IEP as developed'

'I reject the following portions of the IEP, with the
understanding that any portion (s) that I do not
reject will be considered accepted and implemented immediately.
Rejected
portions are as follows: (add your statement or you write 'See attach
letter, dated nn/nn/nn' *)'

'I request a meeting to discuss the rejected IEP or rejected
portion (s)'.
It is suggested that you
write on the "see attach Parent Addendum page" and attach a "Parent Addendum
page" with your issues stated *.

* From The Complete IEP Guide : How to
Advocate for Your Special Ed. Child book by L. Siegel, M. Stewart (1999)), and
also is suggested by Wrightslaw.

The next choice is no longer listed (taken off in 2000) but can still be added:
'I postpone a decision
until the completion of an independent evaluation.' or 'until the completion of
the school evaluations'.This will be considered a
rejected IEP by the school district, so also check off the rejected box as well.

Sign your child's IEP,
before the 30 day review period ends. You should not sign your IEP
until you have reviewed every page of your child's IEP, communicated any differences with your Team chair to ensured that updates have been added
to the IEP, as discussed and agreed to at your Team meeting.

If you do not sign your child's proposed IEP, and you have a previous
year IEP, then
the last signed IEP is in effect (called StayPut).

"Parent Comments: I would like to make the
following comment(s) but realize any comment(s) made that suggest changes to the proposed IEP
will not be implemented unless the IEP is updated or amended." These are comments
that are non-binding. (You can always use the back of the page as
well, by including the statement 'See back of this page.')

Reject portions
or all of the IEP, the school must by law inform the Bureau of Special Education
Appeals (BSEA) within 5 days of the school’s receipt of the rejected
IEP. The BSEA will be
mailing you an information packet, notifying you of your parent rights to Due
Process. (This is the standard procedure, no need to
panic.)

If you also checked off the box requesting a Team
meeting, you should also receive an invitation to Team Meeting to discuss
the issues with the IEP, so that the differences can be worked out
at Team Meeting.

Another option is to have a
Facilitated Team Meeting,
where the Team Meeting is chair by someone from BSEA (instead of school
district). The facilitator helps keep the IEP team members
focused on developing the IEP while addressing conflicts and disagreements that
may arise during the meeting. The facilitator will try to
create an environment in which the IEP team members can listen to one another’s
points of view and work together to develop an IEP that is acceptable to both
the parents and the school district.
If no compromises can be reached, at the Team Meeting the
school district or you can request BSEA Due Process. (Due
Process includes Mediation, which is a recommend first
step.)

Mediation

Is a meeting where parent and the school special
education personal meet with an mediator to discuss openly the areas where
they disagree and try to reach agreement. Mediation is lead
by a third party impartial mediator who helps parents and school
staff clarify the issues and underlying concerns, explore interests, discuss
options and reach mutually satisfying agreements that address the needs of the
student. The mediator does not decide how to resolve the dispute that is
left in the hands of the parent(s) and the school personnel. When the parties
resolve all or some of the issues, the mediator will document what
was agreed to. Both parties need to agree to attend mediation, as
it is a voluntary and informal
process.

Top section: one of
the boxes should be checked off: Full Inclusion
Program, Partial Inclusion Program, substanially Seperate Class, Separate
Day School (Public or Private), Residential School, mixed of IEP
services.

Bottom section: should
have the name of your public school and the dates he will be in the
building.

IEP
Writing Guide, This is a link to Federation for Children with
Special Needs document that has annotated pages of the actual IEP
forms, describing what information would be contain on
each page of the IEP.

IEP
Process Guide (June 2001), is a manual that was created by the
DOE, click here to view/print your own copy . You
can call an order your own copy of this guide, DOE (781) 338-6203.